Definition: Number of hospitalizations for non-fatal self-inflicted injuries among children/youth ages 5-20 (e.g., in 2014, 3,575 California children/youth were hospitalized due to non-fatal self-inflicted injuries).Number of hospitalizations for non-fatal self-inflicted injuries per 100,000 children/youth ages 5-20 (e.g., in 2014, there were 43.1 hospitalizations due to non-fatal self-inflicted injuries per 100,000 California children/youth).

Footnote: These data are measured by the number of discharges from acute care hospital facilities for injuries among children and youth. County-level data reflect the patient's county of residence, not the county in which the hospitalization occurred. The most common types of self-inflicted injury are related to poisoning and cutting/piercing. LNE (Low Number Event) refers to rates that have been suppressed because there were fewer than 20 cases. N/A means that data are not available. Use caution when comparing rates presented on kidsdata.org, which are based on Dec. 2014 population estimates, with those reported by the California Dept. of Public Health, which are based on Nov. 2012 estimates.

Data on self-inflicted injury hospitalizations are available as numbers and rates per 100,000 children/youth ages 5-20 overall, and as numbers by age. Non-fatal suicide attempts and self-mutilation both are included among self-inflicted injuries.

* School connectedness is
a summary measure based on student reports of being treated fairly, feeling close to people, feeling happy, feeling part of school,
and feeling safe at school.

Youth suicide and self-inflicted injury are serious social and public health concerns. Suicide is the second leading cause of death among young people ages 15-19 in the U.S., according to 2014 data (1). A recent national survey found that nearly 1 in 6 high school students reported seriously considering suicide in the previous year, and 1 in 13 reported attempting it (2). In addition, approximately 157,000 youth ages 10-24 are treated for self-inflicted injuries in emergency rooms every year (2). Self-inflicted injuries are not necessarily the result of suicide attempts; in fact, self-harm without the intent to die is more prevalent than self-harm with such intent (3). In total, suicide and self-inflicted injury in the U.S. cost an estimated $45 billion annually in medical expenses and work loss; actual costs may be higher as many suicides and attempted suicides are not reported due to social stigma (4, 5).

Some groups are at a higher risk for suicide than others. Males are more likely to commit suicide, but females are more likely to report attempting suicide (1, 2). Among racial/ethnic groups nationwide, American Indian/Alaska Native youth have the highest suicide rates (1, 2). Research also shows that lesbian, gay, and bisexual youth are more likely to engage in suicidal behavior than their heterosexual peers (6). Several other factors put teens at risk for suicide, including a family history of suicide, past suicide attempts, mental illness, substance abuse, stressful life events, low levels of communication with parents, access to lethal means, exposure to suicidal behavior of others, and incarceration
(1, 2).

Find more information and research about youth suicide and self-inflicted injuries in kidsdata.org's Research & Links section.

In 2014, there were 3,575 hospitalizations for non-fatal self-inflicted injuries among children and youth ages 5-20 in California. While the statewide rate of self-inflicted injury hospitalizations has fluctuated over the last two decades, rates have risen in recent years, from a 22-year low of 34.3 per 100,000 in 2008 to 43.1 per 100,000 in 2014. Most counties with data saw a similar increase during this period. County rates ranged from 24.3 to 71.2 per 100,000 in 2014. Statewide, the majority of hospitalizations for self-inflicted injuries involve youth ages 16-20: 2,164 (or 61%) of all hospitalizations for self-inflicted injuries in 2014.

In 2011-13, nearly one-fifth (19%) of California public school students in grades 9, 11, and non-traditional programs reported seriously considering attempting suicide in the past year. Suicidal ideation was higher among females (vs. males), and highest for multiracial and Native Hawaiian/Pacific Islander students, among racial/ethnic groups with data.

In 2013, 481 California children/youth ages 5-24 were known to have committed suicide: 29 children ages 5-14, 150 ages 15-19, and 302 ages 20-24. The state’s youth suicide rate in 2011-13 was 7.7 per 100,000 youth ages 15-24, slightly higher than previous years, but lower than the rate in 1995-97 (9.4). National comparison data are available from 1999 to 2013; during that period, California's youth suicide rate remained below the U.S. rate, which has risen above 10.0 per 100,000 youth in recent years. Statewide and nationally, many more male youth than female youth commit suicide. In 2013, males accounted for almost 80% of youth suicides in California (354 of 452).

Policy Implications

Suicide is considered a major, preventable public health problem, and it is the second leading cause of death among teens ages 15-19 nationwide (1). Some groups are at higher risk of suicide, such as LGBT youth, American Indian/Alaska Native youth, and those in the juvenile justice and child welfare systems (2). Self-inflicted injury, e.g., cutting and self-hitting, also is a serious public health concern, affecting an estimated 13%-23% of adolescents (3). While self-injury is a risk factor for suicide, many young people engage in self-harm without intent to die, and most youth who hurt themselves do not seek treatment (3). In fact, most children who need mental health treatment, in general, do not receive it (4). Screening, early identification, and access to services are critical in preventing and reducing mental health problems (4). However, experts recommend that policy strategies go beyond preventing and treating problems, to promoting positive youth mental health (4, 5).

Promoting efforts in communities to ensure youth have connections to caring adults and access to safe, positive activities, such as quality after-school programs and mentoring programs (5, 7, 8)

Ensuring adequate funding and training for teachers, school staff, social workers, juvenile justice staff, and others who work directly with young people to recognize signs of suicidal behavior and self-injury, and to refer youth to appropriate services; school training also should focus on how to promote a safe and supportive environment for all students, including LGBT youth (4, 5, 6)

Supporting public education and awareness campaigns to reduce the stigma associated with mental health problems and increase knowledge of warning signs; this could include “mental health first aid” training for wide-ranging audiences, focusing on how to recognize early signs, provide non-professional support, and help youth access community resources (4, 5)

Ensuring that all youth with mental health needs have access to high-quality, culturally appropriate services; as part of this, expanding the workforce of qualified mental health professionals (4, 5)

Encouraging the media to limit publicity and glamorization of youth suicide, e.g., keeping coverage brief and not explicit or sensational, to prevent contagion among other vulnerable youth (5, 10)